Objective To evaluate the diagnostic value of MRI in patients with trigeminal neuralgia. Methods MR manifestations and operative results of 104 patients with trigeminal neuralgia were reviewed retrospectively. Results (1)Of 104 patients with trigeminal neuralgia,75 patients had neurovascular compression or contact of the cisternal portion of the trigeminal nerve at MR imaging and 69 patients were verified by operation;14 patients had C P angle tumors, 13 cases were diagnosed by MRI and the remaining one was verified by the operation and pathology;5 patients had vascular lesions at MR imaging which were verified by microvascular decompression.(2) The percentages of the neurovascular compression or contact,tumors and vascular lesions which were the etiologles of trigeminal neuralgia were 66 3%(69/104),13 5%(14/104) and 4 8%(5/104) respectively.(3)The sensitivity and specificity of MR diagnosis was 89 4% and 96 6% respectively.Conclusion Neurovascular compression of cisternal portion of the fifth cranial nerve is the main cause of trigeminal neuralgia.MR plays an important role in demonstrating the relationship of the fifth cranial nerve to surrounding vascular structures or tumors.

Objective To compare the clinical utility of CT-guided percutaneous biopsies for bone destruction. Methods The retrospective analysis of pathologic outcomes of 89 cases guided by X-ray and MRI, were obtained by needle aspiration (n=13) of 18-20G tru-cut biopsy needles (n=22) and 11-13G Ostycut biopsy needles (n=40). Results Seventy five (84.3%) patients with percutaneous biopsy outcome with concordant results from specimens subsequently obtained at surgery, 14 patients (15.7%) showed pseudo-negative results but no pseudo-positive cases. No obvious differences in pathological results were obtained among these three methods. Conclusions ① CT-guided percutaneous biopsy is effective in the evaluation of skeletal destructive lesions; ② Appropriate selection of percutaneous biopsy method for different kinds of lesion could raise the diagnostie accurracy.

Objective To evaluate the value of CT-guided biopsy of deep-located lesion in the diagnosis of lymphoma. Methods CT-guided percutaneous biopsy was performed in 58 patients with 16-20 gauge core-needle biopsy. The locations of lesion involved mediastinun, lung, retroperitonurn, spleen, kidney, adrenalal and musculoskeletal system. Pathology examination included hematoxylin and eosin staining and immunohistochemical assays. Results In 56 out of 58 cases,the biopsy findings could be confirmed by histologic examination including correctly diagnosed 47 malignant lymphomas, corresponding to a sensitivity of 81%;with fuithecmace subclassification 42 of the 47(89.4%) could be as diagnosed malignant lymphomas on the basis of CT-guided biopsy. Conclusions Biopsy of deeply located lymphoma mass under CT guidance has high diagnostic accuracy and low complication rate with convenience for subclassification of malignant lymphomas.

Objective To study X-ray, CT and MRI features of the spinal giant cell tumors (GCT)and to assess the clinical applied value.Methods Thirty cases of GCT of spine (13 males and 17 females with ages ranging from 17 to 69 years) were reviewed. Allcases underwent radiography,CT was done in 22 patients and MRI was performed in 16 cases.Results One lesion localized in cervical spine,10 in thoracic, 6 in lumbar and another 13 lesions in the sacrum.Osteolytic destruction and vertebral compression were seen on X-ray film. The main CT signs were expanding bone destruction and soft tissue mass. MRI showed low to intermediate signal intensity on T_1WI while high signal on T_2WI.Conclusion X-ray, CT and MRI are of significant value in diagnosis of the spinal GCT, and play an important role in surgical planning.

Objective To determine the utility of diffusion-weighted magnetic resonance imaging ( MR DWI ) in detecting tumor necrosis with histological correlation after neoacljuvant chemotherapy. Methods Conventional MRI and DWI were obtained from 36 patients with histological proven esteosarcoma. Magnetic resonance examinations were performed in all patients before and after 4 cycles of preoperative neoadjuvant chemotherapy. Apparent diffusion coefficients (ADC) were calculated. The degree of tumor necrosis was assessed using the histological Huvos classification after chemotherapy. T-test was performed for testing changes in ADC value between the 2 groups. P value less than 0. 05 were considered as a statistically significant difference. Results The differences in ADC between viable [ (1.06±0. 30) ×10-3mm2/s ] and necrotic [ (2. 39±0. 44 )×10-3mm2/s] tumor were significant (t= 3. 515,P<0. 05). Changes in ADC value was greater in good responses to neoadjuvant chemotherapy than in poor responses, the ADC value in good responses was increased from (1.18±0. 19)×10-3mm2/s to (2. 27±0. 20)×10-3mm2/s, the corresponding value in poor responses was increased from (1.45± 0.11)×10-3mm2/s to (1.83±0. 16)×10-3mm2/s, There was significant difference in changes of ADC values between good responses and poor responses ( t = 4. 981, P < 0. 01 ). Conclusion Diffusion-weighted MRI permits recognition of tumor necrosis induced by chemotherapy in osteosarcoma. DWI is correlated directly with tumor necrosis. They have potential utility in evaluating the preoperative chemotherapy response in patients with primary osteosarcoma.

Objective To compare 1HMRS and DTI findings of Alzheimer disease (AD) patients and normal elderly controls. Methods Fifteen mild AD patients, 20 moderate to severe AD patients and 20 aging controlled normal subjects (CN) were recruited. MRS imaging and DTI were performed on a 1.5 T MRI scanner. A ROI was positioned in the posterior part of the cingulate. MRS data were processed and the metabolite ratios were estimated, including the ratios of NAA/Cr, Cho/Cr, mI/Cr. Comparing with the axial MRS location, we chose the same level to posit the ROIs on both sides of the posterior cingulated fibers on fractional anisotropy map (FA) and mean diffusivity map (MD). Mean spectroscopy data and DTI values for each groups were analysed with Mann-Whitney U non parametric test. Correlations between MRS and DTI values for AD groups were estimated using partial correlations test controlling for the age related bias. Results Compared to normal aging groups, mild AD group showed a significantly lower FA value in the left side of posterior cingulum bundle (0. 549±0. 056 vs 0. 517±0. 058,Z =2. 014,P <0. 05). Whereas, moderate to severe group versus mild AD group revealed significantly elevated MI) value and a decrease in FA value in the right side of posterior cingulate ( FA 0. 517 ± 0. 059 vs 0. 432 ± 0. 073, Z = 3. 216, P < 0. 01 ; MD (0.726±0.041) × 10-3 mm2/s vs (0.761±0.057) × 10-3 mm2/s,Z = 1.970,P <0.05) . Obvious increasing mI/Cr ratio was found in mild AD group ( 0. 61 ± 0. 07 vs 0. 68 ± 0. 12, Z = 2. 911, P < 0. 01 ). NAA/Cr ratio showed gradually decrease in AD groups. Partial correlations analysis revealed a positive correlation between ml/Cr ratio and left posterior cingulated FA value in mild AD group ( r = 0. 586, P < 0. 05) and negative correlation between NAA/Cr and MD value in the right side of posterior cingulated region ( r = - 0. 505, P < 0. 05 ). Conclusions These findings suggested that there were different regional and temporal pattern in different course of AD disease, resulting from axonal loss or gliosis. Combining MRS with DTI alternations could be a better potential indicator and could better explain the pathological changes in AD progression.

Objective To investigate changes of the interhemispheric coordination integrity in patients with hemi-parkinsonism using resting-state functional magnetic resonance imaging(rs-fMRI) homotopy technique called voxel-mirrored homotopic connectivity(VMHC).Methods Sixteen Parkinson disease(PD) patients with right body side motor symptom onset(RPD),15 patients with left side onset(LPD),and 19 age-,gender-,and education-matched healthy controls(HC) were included in this study.rs-fMRI scanning and pre-processed the raw data were performed.Then by using analysis of variance(ANOVA) and two sample t tset,we performed VMHC analyses on rs-fMRI data of these participants(P＜0.05,corrected with AlphaSim,clusters≥16 voxels).Exploratory linear correlations analyses were performed between the VMHC of regions showing significant group differences and the clinical features of LPD or RPD patients.Results Compared with HCs,patients with LPD had significantly reduced VMHC in visual regions,sensorimotor regions,and the cerebellar cortex(voxels size of 17-77,t=-5.06--3.42,P＜0.05).Patients with RPD exhibited decreased VMHC in the prefrontal cortex and sensorimotor regions.Both LPD and RPD groups had increased VMHC in subcortical regions.When compared with the RPD group,the LPD group displayed decreased VMHC in the visual regions,sensorimotor regions(voxels=16 and 18; t=-3.68and-3.87,respectively,both P＜0.05) and increased VMHC in the supramarginal gyrus(voxels=4,t=4.72,P＜0.05);ROI-based correlation analyses indicated that the VMHC in the inferior occipital gyrus and the postcentral gyrus was negatively correlated with the BDI-Ⅱ scores in the LPD group(r=-0.58 and-0.59,respectively; both P＜0.05),and positively correlated with the MMSE scores(r=0.56 and 0.52,respectively;both P＜0.05).In the RPD group,a positive correlation was found for the VMHC in the supramarginal gyrus and the illness duration(r=0.56,P＜0.05) and for the VMHC in the postcentral gyrus and the(mini-mental state exam) MMSE(r=0.53,P＜0.05).Conclusions The differential pattern of deficits in the interhemispheric coordination integrity in hemi-parkinsonism reflected by VMHC may provide insights into the neurological pathophysiology underlying the asymmetry of symptom appearance in PD.

OBJECTIVETo investigate the representation methods of dissolubility property of total alkaloid extract from Peganum hamala in different solvents, and to investigate the evaluation method of the dissolubility property of extracts from traditional Chinese medicine.

METHODThe dissolubility property of the whole extract and markers of harmaline and harmine, as well as the particle diameter distribution of the extract in different solvents were evaluated by precipitation method, solubility test, and the particle diameter test.

RESULTBoth the alkaloid extract and it's index ingredients had good solubility in absolute ethanol, 95% ethanol, and 80% ethanol, while the solubility in 60% ethanol was poor, and worst in water. The sequence of particle diameter of extract in solvents was in the following order water > 95% ethanol > 60% ethanol > 60% ethanol > 80% ethanol.

CONCLUSIONThe extract has good solubility in the ethanol solution whose concentration is over 80%. The results between precipitation method and index components method have certain correlation. The particle diameter method can provide distribution information of the extract in different solvents. Combination of those three methods could reflect the dissolubility property of extracts from traditional Chinese medicine more comprehensively.

Alkaloids ; chemistry ; isolation & purification ; Chemical Fractionation ; methods ; Particle Size ; Peganum ; chemistry ; Plant Extracts ; chemistry ; isolation & purification ; Solubility ; Solvents ; chemistry

OBJECTIVE: To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. MATERIALS AND METHODS: A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. RESULTS: The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p = 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). CONCLUSION: The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.
Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; Male ; Microcirculation ; Middle Aged ; Prognosis ; Prospective Studies ; Regional Blood Flow ; Stomach Neoplasms/*blood supply/pathology/*radiography ; *Tomography, X-Ray Computed

ObjectiveTo explore the characteristics multi-detector-row computed tomography (MDCT)findings of ACTH-independent macronodular adrenal hyperplasia ( AIMAH ).Methods The un-enhanced and contrast-enhanced MDCT features in 24 patients ( 14 males and 10 females) with clinically confirmed AIMAH were retrospectively assessed for the morphology and enhancement patterns.ResultsThe adrenal glands were involved bilaterally in all of the 24 cases( 100％ ).24 patients had massively enlarged multinodular adrenal glands.Nodules were( 1.79 ± 1.02) cm (0.50 ～ 3.85 cm),which usually distorted and completely obscured the normal adrenal glands.The enlarged adrenal glands were still retained the adreniform contour,showed characteristic ginger-like.22 of the 24 ( 91.7 ％ ) hyperplastic nodular glands demonstrated mild homogeneous enhancement.Calcification was revealed in 1 adrenals ( 1/24,4.2％ ).Conclusion MDCT reveals the characteristic morphology and CT attenuation in AIMAH.Combined with its clinical presentation and biochemical findings,AIMAH is able to be diagnosed with high specificity and accuracy on MDCT.